Pennsylvania Department of Health
WHITESTONE CARE CENTER
Building Inspection Results

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Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

There are 35 surveys for this facility. Please select a date to view the survey results.

Surveys don't appear on this website until at least 41 days have elapsed since the exit date of the survey.


WHITESTONE CARE CENTER - Inspection Results	Scope of Citation Number of Residents Affected By Deficient Practice

Initial comments:Name: - Component: -- - Tag: 0000

Based on an Emergency Preparedness Survey completed on February 14, 2024, at Whitestone Care Center, it was determined there were no deficiencies identified with the requirements of 42 CFR 483.73.

Plan of Correction:

Initial comments:Name: WHITESTONE HEALTH CARE CENTER - Component: 01 - Tag: 0000

Facility ID# 22480201
Component 01
Main Building

Based on a Medicare/Medicaid Recertification Survey completed on February 14, 2024, it was determined that Whitestone Care Center was not in compliance with the following requirements of the Life Safety Code for an existing health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.90(a).

This is a two story, Type II (111), protected, noncombustible building, with an unused attic space, that is fully sprinklered.

Plan of Correction:

NFPA 101 STANDARD Hazardous Areas - Enclosure:

This is a less serious (but not lowest level) deficiency and affects more than a limited number of residents, staff, or occurrences. This deficiency is one that results in minimal discomfort to the resident or has the potential (not yet realized) to negatively affect the resident's ability to achieve his/her highest functional status. This deficiency was not found to be throughout this facility.

Hazardous Areas - Enclosure
Hazardous areas are protected by a fire barrier having 1-hour fire resistance rating (with 3/4 hour fire rated doors) or an automatic fire extinguishing system in accordance with 8.7.1 or 19.3.5.9. When the approved automatic fire extinguishing system option is used, the areas shall be separated from other spaces by smoke resisting partitions and doors in accordance with 8.4. Doors shall be self-closing or automatic-closing and permitted to have nonrated or field-applied protective plates that do not exceed 48 inches from the bottom of the door.
Describe the floor and zone locations of hazardous areas that are deficient in REMARKS.
19.3.2.1, 19.3.5.9

Area Automatic Sprinkler Separation N/A
a. Boiler and Fuel-Fired Heater Rooms
b. Laundries (larger than 100 square feet)
c. Repair, Maintenance, and Paint Shops
d. Soiled Linen Rooms (exceeding 64 gallons)
e. Trash Collection Rooms
(exceeding 64 gallons)
f. Combustible Storage Rooms/Spaces
(over 50 square feet)
g. Laboratories (if classified as Severe
Hazard - see K322)

Observations:
Name: WHITESTONE HEALTH CARE CENTER - Component: 01 - Tag: 0321

Based on observation and interview, it was determined the facility failed to maintain hazardous areas in one of four smoke compartments.

Findings include:

1. Observation on Febraury 14, 2024, at 11:00 am, revealed pipe and wiring penetrations sealed with expanding foam in the mechanical room accessed through the janitor closet on the second floor.

Interview at the time of the exit conference with the administrator and facility maintenance representative on February 14, 2024, at 12:00 pm, confirmed an expanding spray foam product was used.

Plan of Correction - To be completed: 02/27/2024

1. Expansion Foam was removed around wiring penetrations and replaced with 3m Fire Caulk
2. House wide audit was completed and areas also corrected.
3. Maintenance and vendor will be in serviced of the proper Fire caulk to be used for penetrations
4. Maintenance Director or designee will spot check 10 areas weekly for one month, 10 areas monthly for 3 months to ensure ongoing compliance and be presented at QAPI.

NFPA 101 STANDARD Sprinkler System - Maintenance and Testing:

This is a less serious (but not lowest level) deficiency and is isolated to the fewest number of residents, staff, or occurrences. This deficiency is one that results in minimal discomfort to the resident or has the potential (not yet realized) to negatively affect the resident's ability to achieve his/her highest functional status.

Sprinkler System - Maintenance and Testing
Automatic sprinkler and standpipe systems are inspected, tested, and maintained in accordance with NFPA 25, Standard for the Inspection, Testing, and Maintaining of Water-based Fire Protection Systems. Records of system design, maintenance, inspection and testing are maintained in a secure location and readily available.
a) Date sprinkler system last checked _____________________
b) Who provided system test ____________________________
c) Water system supply source __________________________
Provide in REMARKS information on coverage for any non-required or partial automatic sprinkler system.
9.7.5, 9.7.7, 9.7.8, and NFPA 25

Observations:
Name: WHITESTONE HEALTH CARE CENTER - Component: 01 - Tag: 0353

Based on observation and interview, it was determined the facility failed to maintain signage for the sprinkler system in one location on one of two floors.

Findings include:

1. Observation on February 14, 2024, at 11:30 am, revealed there was no signage directing emergency services to the fire department connection for the sprinkler system.

Interview at the time of the exit conference with the administrator and facility maintenance representative on February 14, 2024, at 12:00 pm, confirmed the FDC is not readily visible and lacks signage.

Plan of Correction - To be completed: 02/27/2024

1. Power signage was added to Fire Department Connection
2. Maintenance will check weekly to ensure signage is present
3. Maintenance Director or designee will spot check area weekly for one month, and then monthly to ensure ongoing compliance and be presented at QAPI.

NFPA 101 STANDARD Electrical Equipment - Power Cords and Extens:

Electrical Equipment - Power Cords and Extension Cords
Power strips in a patient care vicinity are only used for components of movable patient-care-related electrical equipment (PCREE) assembles that have been assembled by qualified personnel and meet the conditions of 10.2.3.6. Power strips in the patient care vicinity may not be used for non-PCREE (e.g., personal electronics), except in long-term care resident rooms that do not use PCREE. Power strips for PCREE meet UL 1363A or UL 60601-1. Power strips for non-PCREE in the patient care rooms (outside of vicinity) meet UL 1363. In non-patient care rooms, power strips meet other UL standards. All power strips are used with general precautions. Extension cords are not used as a substitute for fixed wiring of a structure. Extension cords used temporarily are removed immediately upon completion of the purpose for which it was installed and meets the conditions of 10.2.4.
10.2.3.6 (NFPA 99), 10.2.4 (NFPA 99), 400-8 (NFPA 70), 590.3(D) (NFPA 70), TIA 12-5

Observations:
Name: WHITESTONE HEALTH CARE CENTER - Component: 01 - Tag: 0920

Based on observation and interview, it was determined the facility failed to monitor for the use of extension cords and power taps in one of four smoke compartments.

Findings include:

1. Observation on February 14, 2024, revealed several small appliances were in use and being powered by a power tap in the business office on the first floor.

Interview at the time of the exit conference with the administrator and facility maintenance representative on February 14, 2024, at 12:00 pm, confirmed the appliances were being powered by a power tap.

Plan of Correction - To be completed: 02/27/2024

1. Power Strip was removed on day of survey.
2. Office and Resident Rooms were checked for power strips and removed.
3. Maintenance Director will in-service staff about the proper use of surge protectors and that they must notify maintenance immediately for removal of improperly used devices.
4. Maintenance Director or designee will spot check 10 areas weekly for one month, 10 rooms monthly for 3 months to ensure ongoing compliance and be presented at QAPI. Facility concierge members will check resident rooms when visiting with residents, weekly.

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